Dis/Advantages of medicine....

Doug lists acetemophin, aspirin and ibuprofin as stuff to pack in a 1st aid kit...what are the advantages and disadvantages of each? I have no known allergies.<br><br>Are Bayer, Advil and Tylenol trusty brands?

It is my understanding that the generic equivalents of all those well known brand names are every bit as good, and they are definitely cheaper.

Acetaminophen or Paracetamol (Tylenol) is for mild - moderate pain. It is a plain analgesic (pure pain relief)<br>Aspirin and Ibuprofen belong to the NSAID (non-steroidal anti-inflammatory drugs) group. It has anti-inflammatory properties like reduction of swelling. It also affects clotting and platelet function and aspirin itself is not a cery good analgesic. Ibuprofen is a much better analgesic. Both ibuprofen and aspirin can cause clotting problems as well as gastritis and if you have a gastric or duodenal ulcer, it may cause bleeding with prolonged use.<br><br>So consult your family physician if you are not sure.

I agree the generics are just as good and much cheaper. Also consider Aleve (Naporoxen Sodium) as a pain releaver / anti-inflamitory. One tablet is good for 8-12 hours, longer than the 4-6 of the others.<br><br>One caution with Tylenol (or the generic). Follow the instructions EXACTLY. An overdose can be fatal. Our local news a couple of months ago had warnings about it. Aparently teens were using it to commit suicide since it is an over the counter drug and easy to get. An overdose causes liver failure. It takes 2-3 days of extreme pain for you to die. Not a good way to go in anyones book. They said unless you were treated within a few hours of ingestion the only other possibility of saving life was an immediate liver transplant.<br><br>Nasty! However, if used as instructed it is a safe and effective pain killer.<br><br>You might want to consider using gel-cap versions. I think the gel coating gives a little extra moisture protection. Also some think it makes them easyer to swallow.<br><br>Enjoy life, Mike

Years ago, when my oldest was a wee todler, he managed to open the child proof cap on a small bottle of mixed meds my wife carries in here purse. It didn't appear that he ingested any, but we called the local ER as a precaustion and they directed us to a poison center. As my wife listed the meds, he stopped her as soon as she mentioned Tylenol and instructed us to give him Oil of Ipacac [spelling?], which caused violent vomiting for the next hour. He was so exhausted, that he literally wqas falling asleep between heaves near the end of the hour when it slowed down. <br><br>It surprised me at the time that with all of the prescription allergy meds my wife carries, it was the over the counter tylenol that caused the most concern.

I am not a doctor, I am a EMT but I would imagine that they were concerned about possible liver damage due to Tylenol overdose.<br><br>Ted Fisher, EMT I/D<br>Vermilion County Search and Rescue

When weight and space is a problem (as in a first aid kit sized to be carried daily) I would not bother to carry comfort medications. This would rule out most pain-killers. If you want a pain-killer to make it possible to go on with a broken femur then nothing short of morphine will do. If your pain comes from something less than a broken bone then suck it up and walk on. You will have much better use of the same volume of gauze and if you need the gauze the need is much more urgent.<br><br>Other medications may be worth carrying. If you have allergies and usually carry an Epi-pen or inhaler then carry an extra by all means! These are life saving medications that you will die without if you need them. If you have a heart condition then carry some aspirins and some nitro as suggested by your physician.<br> <br>OTC medications that might actually save your life are rare. the only examples that spring to mind are those to manage your gut. Activated charcoal and syrup of ipicac both will help in cases of poisoning. But you must educate yourself on when to use which. Some pepto or Tums can keep you from dehydrating while your imune system and liver overcomes whatever is causing the diarhea. <br><br> In most situations that this forum considers there is a time-limit to the expected duration and a greater likelyhood of trauma than medical emergencies. Most illnesses will be better left untreated until the event has passed and the local hospital re-opens or you are rescued and evacuated to an operational hospital. Traumatic emergencies don't often require medications but can require an abundant supply of bandaging. I would be able to stuff between 5 and 10 sterile 4X4 bandages in the space taken up by a small bottle of aspirin. The bandages may make the difference between someone bleeding to death and making it out. The aspirin may make someone a little more comfortable after they bonk their head on the side of the plane during the unexpected landing meanwhile if they are going into shock due to internal bleeding then the aspirin will actually help them bleed out more quickly and thus limit the strain that they placed on the resources of the group. It is not all bad depending on how you look at it. <br> <br>In the more long-term situations the medical needs of a group or individual will require stronger medication. You must be educated to do more good than harm with such. If you are educated in herbology and lucky enough to be in an event where the herbs grow and in the season for them to be growing then this may help. Otherwise you need to have specific medical knowledge adequate to the accurate diagnosis and supplies adequate to the treatment of a variety of disorders. The most useful are the various anti-biotics because the symptoms of infection are fairly easily diagnosed with minimal training and the access to anti-biotics that are relatively harmless and highly effective is greater.<br><br>I would highly recommend that anyone interested in this aspect of preparedness take the time to sign up for and complete an basic EMT course and volunteer for a season or two on a local ambulance. Nothing prepares you better than experience. And while your'e at it you will be rendering a great service to your community and making some great friends.

>>>If you are educated in herbology and lucky enough to be in an event where the herbs grow and in the season for them to be growing then this may help.<<<<br><br>Proceed with caution!<br><br>Approx. 1/2 of medications today are either directly derived from plants or are synthesised from research on herbal cures. But very few people are skilled enough to treat illnesses in the wild using herbs. <br><br>I have a Peterson Field Guide on Medicinal Plants. I bought it primarily as an identification guide when I used it to ID Sweetfern, which is not a fern BTW. I chuckle whenever I read the entries on most of the plants listed as they seem to have been used at one time or another as a cure for almost every ailment under the sun.<br><br>As I mentioned above, most of our medicines were originally derived from plants, so many of the potential uses in the wild may be valid. But it takes a lot of training and research and shared knowledge to be able to use them approprietly.<br><br>Digitalis, for an example, can be used for heart trouble, and is the basis for prescription drugs for the same. But if improperly used or dosed using the wild plant, it can be harmful or even fatal. And it's not a simple means of simply identifying the plants. Often the season, time of day collected, preparation or combiation with other plants have an effect on the herbs effectiveness. <br><br>I remember an article about an anthropologist who worked with a rainforest indian tribe, noticed an interesting plant in the "medicine" man's kit bag used to cure various ailemnts. The medicine man gave him a sample, which he forwarded to a scientist in Europe for analysis. It turned out to be very effective in killing cancerous cells of some type. So the scientest asked for more. The anthropologist asked the medicine man for more, and he refused, fearful of the intentions and/or potential results. The anthropologist took detail notes so he was able to identify the and collect more of the plant from the forest. But this sample had negative results in the lab. Something the medicine man did or how he did it had an effect on the plants effectiveness. <br><br>Sweetfern, BTW, is an astringent, which means a poltice applied to a wound will help slow or stop bleeding and aid in healing. Although I have never tried it myself so I can't vouch for its effectiveness.

I agree that it doesn't make much sense to carry aspirin, tylenol or ibuprofen for the minor aches and pains that these will relieve, when space is at such a premium in the psk, although I certainly carry them in my first aid kit. However, I do think that it is essential to carry Zithromax (azithrowmycin) which is a prescription antibotic that gives you a full cycle of treatment in 6 tablets. I also think that 8 tablets of Vicodin or Roxicet or a similar narcotic ( combined with acetomeniphen) is a hugely valuable addition. It is not morphine, but will take care of a lot of that broken bone pain for a couple of days. If you vacuum pack these as in Doug's kit, they don't take up much space and have a reasonable shelf life. You have to get a prescription, but your regular family doctor will almost certainly provide one for this purpose. Along with the prescription you could have her give you the information on the proper indications for use of these medications. I do carry two aspirin in my psk for use in a potential heart attack situation. My doctor believes that taking two aspirin at the initial signs of a heart attack may be very helpful, but this is NOT a universally accepted practice, so you should speak to a doctor you trust and sort out your feelings about that. If you do give a heart attack victim aspirin, or anything else, it is essential that emergency personnel know when and what amount was administered.<br><br>Robb

Hey Guys,<br><br>Thought I'd throw my two cents in.<br><br>I would give up room in the PSK to include OTC pain relievers. Having spent many a night in the woods under less than ideal circumstances (courtesy of Uncle Sam) I can attest to a need for them. I can't forsee a survival situation where they wouldn't be useful. Too many aches and pains and bumps and bruises are distracting, can keep you from sleeping, and make life just plain miserable. None of which would be helpful in a survival situation. BTW, dehydration (a very real possibilty in a survival situation) is a leading cause of aches and pains. Bad enough being thirsty, add to that just feeling like crap...<br><br>I also carry stronger stuff, but can't see taking it for a stress headache or for a sore, exhausted body. The OTC meds could be invaluable.<br><br>Andy

Doug and CK : Please comment on the following statements from an article by Anthony Acerrano in the May 2002 issue of Sports Afield. "you don't even need to boil water for 5 to 10 minutes, as once was believed. By the time water comes to a full roll, it has long passed the temperature needed to kill the bad bugs." "....halogens will not kill Cryptosporidium cysts..." A.A. also recomends a purifier : General Ecology First Need Deluxe. Opinion ? Directing these questions to the Dynamic Duo is not to be interpreted to exclude others. It's only that I am very, very interested in their comments. Thanks.

I will have to read the article. He may very well be correct, but my initial reaction is a big no. Water quality worldwide has suffered pollution from heavy metals, pesticides, fertilizers and bacterial "blooms". Some people scoff at mechanical filters as a marketing ploy "we strain the big stuff through our teeth with a iodine chaser grunt, grunt". I was under a doctor's care for giardia that ignored treatment for months. I boil and treat chemically AND use a mechanical filter if available.

Chris - I think I read the same article recently - I passed over it lightly because without definitive evidence I am not taking the "info" as accurate.<br><br>I have read many times for many years that giardia does not treat us all equally... empirical evidence at least suggests that a significant number of folks are not very susceptable to ill effects - but there are many variables (like concentration), so don't read too much into my statement.<br><br>Iodine has worked very well *for me* so far and I've been extended periods with some pretty crummy water. Chlorine has been successful in munincipal treatment practically forever (as those things go) - but without test kits in the field to verify a "safe" residual, I do not have the same degree of confidence. But it worked great - and I can say with certainty that the surface water that was treated with it was much worse then than it is today, at least where I live. I shudder at some of what is documented fact about what used to flow by here... and my memories of the same.<br><br>Filters can work also - I've employed large commercial (almost munincipal level) filters, and of course, ROWPU units (reverse osmosis). But I have no first hand experience with the portable filters, having only read the pros and cons over the years since they became widely available.<br><br>Boiling works great as far as I know. Went about a month on water that was so loaded with organics that it looked like dark tea - we boiled (wood fires) because we felt that chemical treatment would be iffy with all that organic matter to oxidize. No one got sick...<br><br>And I DO strain out the big chunks first! <grin> - but not with my teeth.<br><br>I look forward to hearing more about the claims made in that article - I'm a bit skeptical without proof.<br><br>Regards,<br><br>Tom

Water treatment is a little bit like snake bite cures. Since not everyone really gets sick, a lot of questionable methods seem to work, and thus acquire a lot of anecdotal support.<br><br>Boiling is the most definitive way of dealing with bacterial contamination, which is probably overall the greatest general problem. The old saw about 5 to 10 minute boiling has been refuted by James Wilkerson, MD, author of Mountaineering Medicine. The longer interval arose from the need to sterilize bandages, which does require the longer interval to deal with special septic bacteria which are a problem in that context.<br><br>It is of academic interest to note that there are extremophile bacteria that thrive, not just live, in boiling water, like the bacteria from Yellowstone NP that have proved so useful in PCR DNA studies. Luckily these bacteria don't give us gut feelings.<br><br>Thirty to forty years ago, I used to drink willy-nilly from all sorts of clear, sparkling mountain streams inthe SW. I never got sick. I am much more cautious now. Filters eem to work fine, meaning I have never gotten sick, with most sources. They are quick and convenient. Boiling has worked for me with such sources as water drawn from open irrigation ditches in SE China, so that is my preferred method - definitive and requires no extra equipment. The NPS put out a brochure on water treatment recently and they stated that boiling was the surest way to purify water. If you can't trust a ranger, who can you trust?<br><br>Some of the contaminants of concern, like heavy metals, probably aren't an issue unless you will use the water for an extended period of time, as opposed to a canteenful while passing through (unless arsenic is present!). I have used some very questionable sources, reasoning that the water might make me sick, but it will get me to town, where I can be cured. Dehydration can kill within hours; everything else is treatable.

You make some excellent points - everyone's needs are different, so my FAK will not necessarily be like your FAK. EMT training is an excellent idea, as is practical experience. I would only add that even better than service on an ambulance is time spent with your local SAR unit. If you live near the outdoors, you will learn a lot about survival, both directly and indirectly. You do things in the woods you would never consider when you are an ambulance ride away from the ER.

<blockquote><font size=1>In reply to:</font><hr><p>I would only add that even better than service on an ambulance is time spent with your local SAR unit. If you live near the outdoors, you will learn a lot about survival, both directly and indirectly. <p><hr></blockquote><p><br><br>Very true and relevent! I am sure that you might learn as much by the example of those in need of rescue as by the experience of rescueing them. A SAR commitment might be somewhat more time demanding than a night / week on the local ambulance though.

OK I guess I should have asked:<br>What would you use acetemophin, ibuprofin and aspirin for? I leave them in my 1st aid kit...more for headaches during class or if I am stuck somewhere and driving home, the last thing I need is to be distracted. If I have no known allergies, are the 3 aforementioned drugs all in the same, is one better than the other, or should I carry all 3 for different purposes? I don't mind giving up space, and really they don't take up much. I just leave two pairs of each pills in a plastic container that is half the size of a film can.

Regarding the statements quoted:<br><br>"you don't even need to boil water for 5 to 10 minutes"<br><br>This is correct. It only needs to reach the boiling point. In fact it actually doesn't need to get that hot but that provides an easy to identify indication that it is hot enough. Nor do you have to "add a minute for every 1000 ft." as was once believed. These are all old wives tales.<br><br>"halogens will not kill Cryptosporidium cysts..." "<br><br>Correct, as noted at http://www.equipped.org/watrfood.htm#WaterPurification<br><br>First Need review is at http://www.equipped.org/watrfood.htm#GeneralEcology. Bit dated but the filter is still essentially the same. I used one for years. Downside is that it cannot be cleaned in the field. <br><br>General Ecology sells a kit with Potable Aqua and their filter. This isn't a bad combo for anyone and covers most all the bases. What most filters will not easily remove is chemical toxins. Even those with charcoal pre or post filters won't entirely clean up some toxins.<br><br>Bottom line is you do the best you can with the available resources and time, use common sense about sources, then drink. <br><br>

All three OTC pain-killers mentioned are roughly equal as pain-killers in my experience. They all have other and different secondary uses. Ibuprofin will work as a muscle relaxant which the other two won't. Aspirin will work as a blood thinner which is why many recommend it at first sign of a heart attack. If the heart attack is caused by an embolism then aspirin will potentially thin the blood enough to allow it past the embolism and save the threatened cardiac muscle. Aspirin will also lower Blood pressure. Acetominophin is an analgesic pure and simple. I find that all of these are synergistic with caffiene for minor head aches. (That may be due to my personal caffiene addiction ;^O).

Doug, CK, et al : Thanks for the excellent critique !!! _________________________________________________ Proverbs 21:19

Skunkabilly,<br><br><br>Personally, I carry Ibuprofen. As an OTC pain reliever/fever reducer/swelling reducer, it works great. Tylenol (acetomenifen sp?) has similar properties. Asprin does not reduce fevers or swelling and has the risk of thinning blood (which is why it's reccomended for heart attacks). I have no history of heart problems or high blood pressure, and I like the additional benefits of the other drugs, so I carry Ibuprofen. Why not the Tylenol? Ibuprofen is cheaper around here.<br><br>What do use it for? In the normal course of my life, I take it often (2-3 times per week). I work construction...lots of heavy lifting, bumps, bruises, contusions, strained/sprained this and that, the occasional laceration, etc... Sometimes taking something to take the edge off of one (or two, or three...) of those types of things is all that keeps me going. I also suffer from migraines, and while 800mg of Motrin doesn't solve one of those, it takes me from being completely unable to function (curled up on the floor, vomitting) to a very limited amount of function. <br><br>In a survival situation, I would take them for similar things. A clear head is the most important survival tool. It is hard to think and concentrate when you're hurting.<br><br><br>Andy

Here's a relevent article on Giardia.<br><br> Giardia

Informative article on giardia lamblia... made sense to me. His conclusions tallied with what I *thought* I knew, but he's done properly documented research, which makes it very useful to me. The "hot water" specifics were especially interesting (Chris and Doug are right, no surprise), and something I was interested in knowing more about. Thanks for the link. <br><br>I recently read an additional bit of giardia trivia - it may have been here - that I have not verified: Supposedly giardia cysts are sufficiently denser than fresh water that they rapidly sink in deep unroiled clear water - the article snippet was about drinking lake water in the Boundary Waters, IIRC. Hmmm. We had to chop thru the ice for water the last time I was there (wintertime) and I'm certain that a lot of folks who ply those waters (thawed or frozen) are not "good" about human waste management. Yet common practice seems to be drawing the water from the lakes and simply using it. Any microbiologists here that can comment? <br><br>Now for a similar article about our other major protozoan buddy, cryptosporodium parvum... anyone find a good one yet? I've only made a cursory check so far and am faintly skeptical of the utility of most of what I glanced at. There was one Canadian article that was pretty good -"realistically cautious" is how I would characterize it - but it didn't credit any scientific sources. The rest of what I've glanced at is pretty focused on munincipal / residential type situations (science + technology + legal = paranoia) or "you should buy our product because..." <br><br>I did find ample scientific evidence regarding the futility of using chlorine alone, but zip nada nothing scientific about iodine. CDC says that iodine will work, but it takes 15 hours to be certain against Crypto. parvum. Chlorine dioxide (AquaMira) is claimed to be effective, but again, I've not seen hard evidence yet. Am very interested in learning more about crypto. p. as it pertains to our main interests here (survival) and more directly, to travel away from the munincipal spigot... if anyone finds noteworthy info, please share!<br><br>Both these beasties (and other critters) bring me back to an earlier question - has anyone been using Chlor-floc? I'm guessing that works by floculating most (all?) the suspended solids - specifically including the bugs - and then chlorinating the super natent. Regardless, does anyone know how effective that approach is?<br><br>Regards,<br><br>Tom

Minime <br>I would like to correct some of the facts about ibuprofen. It does not have any muslce relaxant properties. It is in the same class as aspirin. I terms of efficacy aspirin and acetaminophen (paracetamol) are about equal, Ibuprofen is slightly stronger than the other two. Naproxen Sodium 275mg is next better then come the analgesic combinations.<br>Paracetamol + orphenadrine - has muscle relaxant properties<br>Paracetamol + codiene - stronger than paracetamol alone (8 mg codiene)<br>Vicodine is probably stronger than Para+codiene<br>Tramadol has the efficacy of intramuscular pethidine<br>then come the injectables - pethidine and morphine (which are carried only by medical personnel )<br><br>Another thing about aspirin. If you are having severe angina and on the verge of a heart attack, 3 sublingual aspirin 100mg will help to reduce the effects of the clot on completely occluding your affected coronary vessel. Of course if you don't get to a medical facility thereafter, well, your luck might just run out.<br>

Beachdoc are you still with us? Cryptosporidium seems to be the latest wilderness bogeyman ( supplanting lymne disease and Susquatch.) I have to wonder if we are also handicapping ourselves from the outset. It's a given most people are in a state of dehydration in daily life. Caffeins, sugars ( all the good stuff ;O) are often actually detrimental. It is no accident that a cultured yogurt after intestinal illness quickly restores our gut flora. We need to learn more!

Paracetamol / acetaminophen / paracetamol is a safe antipyretic and antiemetic.<br>The dose which will cause toxic liver damage in an adult is >10000 mg (>20 500mg tablets).<br>This is was beyond what the recommended daily dosages are.<br>Paracetamol overdose can cause fulminant liver failure in an overdose but there is an antidote - N-acetylcystine. This of course has to be given ASAP.<br><br>So just stick to the recommended dosing and you won't go far wrong.<br><br>However, even prolonged use of aspirin and ibuprofen at the recommended dosages can lead to gastritis / gastric erosions and even gastric perforation. This is because of the continued effect of inhibiting one of the enzymes which plays a part in the gastroprotective mucus secretion in the GIT. <br><br>SO long term uses of NSAIDS also has its inherent risks.. :-)<br><br>

It seems the question began with essentially over the counter pain meds. Knowing what are appropriate and for who and when is the critical question. Knowing a few pain reducing measures is also helpfull. Applying heat or cold, massaging or elevating the injury and some acupuncture pressure points are non invasive options. Limiting material options to a single PSK led me to early adopt a two box system. One is solely devoted to first aid. I can access it instead of digging through sparklites and condoms for a bandaid while bleeding to death, and carry substantially more. Carrying two in opposite pockets also helps keep me from drifting to the left of a compass bearing ;O)

Thanks for the correction on the activity of ibuprofen. I went to look up better details and found this very interesting link on which drugs do what.

For a really novel (urban survival in So Cal???) approach, see this link. (I recall that c. parvum is supposedly hard to kill with short exposure time to UV due to shell thickness).<br><br>I found mixed claims about chlorine dioxide (AquaMira) VS c. parvum, so caveat emptor as always.<br><br>Having a devil of a time getting useful info about Chlor-Floc - I guess the issue "emergency kit" includes a reusable mixing bag/bladder and a reusable filter. If, as the name implies, the chemical disinfectant is chlorine, surely it is pH / temperature dependant??? Wierder yet, the current military pubs I've looked at that mention Chlor-Floc are still listing iodine as the prefered chemical treatment (at the individual level)... Chemical name for it is sodium dichloro-isocyanurate - sounds like a powdered superglue with chlorine <grin>.<br><br>BTW, boiling does not render water safe for storage, but only for relatively immediate use - many bacterial spores survive boiling (not a problem to drink them, but if the water sits for days, I guess they can eventually re-infect the water...?)<br><br>Oh - another bit of trivia I found is that many individuals seem to become "immune" to c. parvum, but the mechanism is not established yet. Also, many folks are asymptomatic, just like with giardia. Not everyone gets sick... in fact, some studies suggest that most of us won't get sick, or only slightly. No comfort to those who have died from it, of course.<br><br>When I was in a 3rd world country during a bit of civil disorder, the MSF folks and others told me that more people were dying from the effects of diharea (mainly dehydration) than starvation - bad water and/or hygene. I've often recalled that and near as I can tell, there's quite a body of evidence that supports that claim.<br><br>Now, if I could only fit a PUR in my PSK... nah. I'll stick to iodine for now. I must admit tho, that the c. parvum info is making me at least consider a filter for planned trips. Look forward to reading whatever additional info folks dig up on the topic.

Doug - a quick question: Are filter units (esp. thinking about ceramic filters) in any danger of being damaged by freezing? Not idle curiousity; I've often wondered what happens. Say I use a filter to replenish my water bottles and then stow it in my pack - in sub-freezing conditions. Filter elements would be wet from use. When the unit freezes, 1) is there any damage to the filter from expansion 2) next time I use the filter, is it going to be a pain to move water thru it until the durn thing "warms up" to the water temp or...??? Thanks in advance.<br><br>Tom

trusbx: Please don't take this the wrong way, I'm just asking for my own peace of mind, but what are your qualifications? I'm not an EMR or paramedic, but I am a St John Ambulance (of Canada) instructor, qualified to teach Standard First Aid and recently qualified to teach their Wildnerness First Aid course as well. <br><br>While what you say about Acetominophen is, I believe, true in general, there are medical conditions (esp. pre-existing liver damage) in which the lethal dosage of Tylenol can be well below the 20 tablets you cited as a maximum safe dosage. (The Alberta College of Paramedics will not allow anyone below paramedic level to give any medication, even aspirin. St John Ambulance protocols allow me to give aspirin for a suspected heart attack, but not for pain relief.) Anything other than aspirin, I (technically) need permission from a doctor. (Of course, I don't usually count the number of aspirin tablets I have; so if I put the bottle down and turn my back, I have no way of knowing whether any of them were taken. :-) But I would certainly explain some of the potential side effects first. And I would never do this with a bottle of Tylenol, especially if I suspected the patient had a problem with alcoholism, for example.

Tom,<br><br>A frozen filter is bad juju. The ceramics will crack, I've also heard of problems with others. You'll note that the user manual for Katydan includes warnings to that effect. They must be pumped out after use. A damp filter isn't a problem, to best of my knowledge, only one filled with water. If the damp filter "freezes," any water warm enough to be liquid will quickly melt any ice particlestrapped in the filter, may take a bit of extra time/pressure for the first few pumps, but in my experience it's not really much of an issue. <br><br>I might as well take this opportunity to remind folks that flters that are meant to be cleaned (as opposed to replaced) should be cleaned after every trip and dried according to instructions.<br>

I wouldn't presume to speak for Doug, but I think either Chris or I can answer this from experience- they crack. Specifically, the expensive silver-laden Katadyn ceramic filter elements crack when they freeze. I think they would have to dry outside of the filter to prevent it- or maybe heat?<br><br>This might seem like a disadvantage, but I really don't think ANY sub-micron filter is going to like the formation of ice crystals one little bit- and others might fail in ways that won't let you know they're not working anymore. I'm not sure that's better.<br><br>I've always slept with water bottles in cold weather (foot of the bag), and I've included the filter (inside a plastic bag) when I was carrying one. I suppose in really cold weather, you're going to have to keep it inside your jacket somehow during the day. With my old (white!) Katadyn "Pocket" filter (way too big for a pocket) this would have been a real pain- with my new "mini" it shouldn't be a problem.

Sorry, I just checked your profile and see that you're a medical doctor. Should have done that first. Ignore me. :-)

Thanks for the answers, Doug and Presumed_Lost.<br><br>Tom

One of my former co-workers, left a bottle of OTC pain tablets that she picked up in Canada. They are called A.C.&C. Tablets. Each tablet contains:<br><br>Acetylsalicyclic Acid (asperin) 325 mg<br>Caffeine 15 mg<br>Codeine Phosphate 8 mg<br><br>This combinaiton works really well when others have failed. We have only 6 tablet left, so we guard them as if they were made of gold. It does contain asperin, so the cautions on blood thinning and alergies apply, especially in a wilderness area.<br><br>My only problem is that as a US citizen, my government doesn't trust me with this pain reliever because it contains codeine. I may have to plan a road trip up to the Canada just to make an ACC run! ;-)

A recent National Geographic Magazine issue had an article on infectious deseases in the world today. I haven't read the article yet, but I recall seeing a graph, using a color coded world atlas, showing the relative distribution of deaseases in the world today. Diharea was by the far the most common and prevelent desease.

Your post contains some incorrect information that I think is important to challenge. First of all, if I were faced with a survival situation, the absolute LAST antibiotic I would select is Zithromax (aka azithromycin). It has very limited usefullness and none that I could imagine in a survival situation. You are interested, I presume, in staph and strep coverage and drugs like Cephalexin are more suitable.<br>Secondly, there is NO question in any medical circle that aspirin should be given to a person with chest pain suspected of having a cardiac origin.<br>There is little need to carry aspirin, acetominophen, and ibuprofen. They are interchangable. I would carry ibuprofen alone.

Bill, don't get caught bringing a controlled (schedule IV) narcotic across the border!<br>Codeine is a narcotic and a controlled drug, in the same class as a lot of other addicting drugs that the govt does not trust us (anymore) to have unlimited access.

Beachdoc, Glad to see your still with us! Want a real horror of improper medication? I have encouraged many of the local equestrian community to carry a few items; whistle, matches and a small aid kit for horse and rider. I have discovered many horsemen self medicate with butazolidin, a pain killer for horses! Some of the DVMs even dismissed my concerns if it is done infrequently! This in spite of one known jocky dying from long term use. I am currently packing my own placebo; darnitoll and extra strength forgetitoll in adult proof containers ( Altoid mints, I had to find a use for some of those dumped candies.)

You mention several things that you would not carry due to bulk and then mention several items that are actually bulky in a first aid kit that is carried everyday. I would suggest that there is nothing that will make a real differnce from a medical perspective that will fit comfortably in your pockets.<br>I have always carried the stuff that I need to open an airway in my car: laryngoscope, blades, endotracheal tubes, and paralytic drugs. Also carry epinephrine in my car when I don't have a trauma bag.<br>From a practical standpoint, dressings will not prevent a patient from bleeding to death and ipecac and charcoal will not "save" a poisoned patient. In my emergency kit, I don't carry ipecac and can't remember the last time in the ER that we used charcoal.<br>Your comment about education and experience is most valuable. The most important preparation that you can have for emergency medical care is training.

I would have thought the ER would have advised you to bring Junior in for a tylenol level rather than administer ipecac. Once ipecac is administered, then the specific treatment for acetominophen overdose/toxicity can not be given orally.<br>

This happened about 12 years ago. I don't know if that makes a difference (probobly not). <br><br>The vial also contained other meds that my wife carries, such as Marex [spell?], Benedril and a few others. So I suspect that there was enough potential variety that he or she decided to just purge it all from his stomach. <br><br>Actually, I even have my doubts that he even took one tablet. He had opened the container and dumped them on the floor while he went on playing with other items in her purse. There was no way of counting to determine if he took any, but there seemed to enough left to indicate that he had not. We also did not find any trace in his mouth. Although both assuptions are inconclusive, we felt reasonably sur that if he did take any, it was a small amount.<br><br>Or maybe we just didn't get one of the better folks on staff.<br><br>But I will NEVER forget the physically demanding process that the ipecac brought on. I would never want to put myself through that unless I absolutely had to do so.

Beachdoc wrote: "there is NO question in any medical circle that aspirin should be given to a person with chest pain suspected of having a cardiac origin."<br><br>Sorry Beachdoc, I may be being a little dense here, so just for me... ;-)<br><br>Are you saying that the three drugs you listed (aspirin, acetominophen, and ibuprofen) are interchangable even for the treatment of the suspected cardiac problem?<br><br>I only ask because I went on a first aid course last year, and we were told specifically to administer *only* aspirin in this case.<br><br>Regards, Pat Galea

No you were correct. Aspirin is useful to limit the "stickiness" of platelets in the blood that otherwise might get together to form a clot.<br>From a pain relief standpoint, I don't think one is "stronger" than another, and that includes all of the patent pain remedies that are pushed on the unsuspecting public. If I were to be stranded on an island with a choice of aspirin or tylenol I would elect the aspirin only because of it's anti-inflammatory effects. Now with ibuprofen an OTC drug I would select it or Aleve (longer acting than ibuprofen)

Many thanks for the clarification!<br><br>I always carry ibuprofen as my painkiller of choice for myself. For some reason, I find it massively more effective than any other OTC medicine. And it seems to clear up a whole host of associated symptoms at the same time. (And it appears to give me a small 'high', but that could be just imaginary because the pain has gone! ;-) )<br><br>Regards, Pat Galea

Anyone familiar with the Steri-Pen, a monochromatic low pressure UV (245nm) purifier? I read the provided test reports and at first glance, it seems to be legitimate... website is here

None taken. :-)<br><br>I'm a family physician in private practice in Singapore.<br>My Qualifications are M.B.,B.S. (eq. to M.D. )<br><br>Of course if you have pre-existing liver damage or liver cirrhosis then the dosage of acetaminophen should be reduced. But generally we out here in asia prefer acetaminophen as the first drug of choice.<br><br>Chris

Yes, I have just puchased one. Since I work in a laboratory, I have tested the pen aganst two organisms. E.coli and a Proteus species, both commonly found in fecal contaminated water. The test was strickly qualitative, I made a very heavy suspension of the two organisms (way beyond what would be encountered in nature). After the first expouse with the pen, I was still able to culture viable organisms, however, the numbers of organism was significanly reduced. I exposed the solution to a second dose of the UV, this time no viable organisms were recovered. If the claims of the manufacter are valid the pen has a broad spectum of kill. The pen is however expensive.